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Beware of Flights into Health

What is a “flight into health” and why is it the opposite of what it sounds like and a dynamic to avoid? It is: “In dynamic psychotherapy, the early but often only temporary disappearance of the symptoms that ostensibly brought the patient into therapy; a defense against the anxiety engendered by the prospect of further psychoanalytic exploration of the patient's conflicts. (Flight into Health - Medical Definition from MediLexicon, https://www.medilexicon.com/dictionary/34029, accessed 11/24/18)

I see “flights into health” often in my practice. All psychotherapists do. So that you can recognize them in yourself and people you know, here are some examples.

  • A client prone to depression who has no meaningful work and hasn’t found the right

man comes back from a vacation abroad and is jazzed and hopeful about her future because of her experience. After a while, her depression returns. She’s been in therapy for years and this vacation → happiness → depression pattern happens frequently. She’s made excellent progress in therapy in many ways but hasn’t dealt with some seminal issues which would truly turn her life around.

  • A client with a drug and alcohol problem refuses to attend substance abuse

meetings to help him recover and believes he can kick his habits through outpatient therapy alone. He abstains for a short time, then relapses until he finds a fringe church and becomes highly involved in it. He stops using drugs, reduces his alcohol use and comes into every session talking about how wonderful he feels and describing all the time he’s spending with his church friends—and avoiding discussion of anything else.

  • A couple who both have severe trauma histories make little progress in therapy in

resolving their marital problems. Each time they acknowledge the need to talk about the abuse they suffered in childhood, they come up with a new crisis in their lives that needs attention—she spends too much money shopping, he’s out all the time with his friends, her sister wants to move in with them, they need to put their cat to sleep. They announce they’re having a baby and get along better with the pregnancy to focus on.

These are all examples of flights into health in which a client shifts direction (consciously or unconsciously) in order to avoid psychic pain. Sometimes the pain is due to childhood trauma or abuse. Other times it’s a more recent event or loss. A widower avoids grieving the death of his spouse by immediately entering into a new romantic relationship. A woman who has been raped refuses to discuss it and moves to another town, saying that she’s fine and no longer needs therapy. Dieting when you know it won’t work long-term is also a type of flight into health.

If you often run toward happiness and run away from focusing on resolving your problems, you might be prone to flights of health. You may also see this behavior in others, which causes mixed feelings: You want to be happy for them, but sense that what they’re doing is only a temporary Band-Aid for their problems. You won’t recover from dysfunctional eating by looking for quick fixes. As author Geneen Roth says, The only way out is through.

Best,

Karen

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